MACKLANDER LLC NPI 1801134739

NPI Information

NPI: 1801134739
Provider Name: MACKLANDER, LLC
Classification: Clinic/Center - 261QD1600X
Specialization: Developmental Disabilities
Entity Type: Organization
Doing Business As: MACKSIMUM ALLIANCE
Address: 1514 BALDWIN LAKES DR
GROVETOWN, GA
ZIP 30813
Phone: (706) 854-0555

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NPI Details

MACKLANDER, LLC is a developmental disabilities clinic center in Grovetown, GA. The provider is an entity, facility, or distinct part of a facility providing comprehensive, multidiscipline diagnostic, treatment, therapy, training, and counseling services to children with congenital disorders that precipitate developmental delays and in many instances mental deficiencies (e.g., Cerebral Palsy, metabolic disorders, Sturge-Weber Syndrome, etc.). MACKLANDER, LLC NPI is 1801134739. The provider is registered as an organization entity type.
The provider Is Doing Business As Macksimum Alliance.

The provider's business location address is:

1514 BALDWIN LAKES DR
GROVETOWN, GA
ZIP 30813-887
Phone: (706) 854-0555
Fax: (706) 651-9677

The provider's authorized official is Shelley Diane Mack .
The authorized official title is Administrator and has the following contact phone number (706) 854-0555.

The enumeration date for this NPI number is 1/28/2013 and was last updated on 1/28/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	251J00000X	Nursing Care		036-R-0525	GEORGIA	No
2	261QD1600X	Clinic/Center	Developmental Disabilities	036-R-0525	GEORGIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	366878280A	MEDICAID	GEORGIA
2	366878280B	MEDICAID	GEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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